Assessment of the Relationship Between Leukocyte Count and Neutrophil-to-Lymphocyte Ratio and Clinical Course in Non-Variceal Upper Gastrointestinal System Bleeding

Year 2018, , 320 - 326, 29.06.2018

Altay Kandemir , Mehmet Süle İrfan Yavaşoğlu , Mevlüt Türe , Adil Coşkun Abdülvahit Yükselen M. Hadi Yaşa

https://doi.org/10.31832/smj.414202

Cited By: 1

Abstract

Objective: Nonvariceal
upper gastrointestinal system bleeding (NVUGIB) is a life-threatening condition
that can lead to mortality. It is
important to identify the risk factors in terms of prognosis and mortality in
patients with NVUGIB. In this
study, we assessed the relationship between leukocytosis and neutrophil-to-lymphocyte
ratio and the clinical course in patients with NVUGIB.

Materials and Methods:
We
included 156 patients who were diagnosed with NVUGIB between September 2013 and
March 2017 in our clinic. The
relationship between demographic data, endoscopic findings, need for
erythrocyte suspension, length of hospital stay, need for intensive care, need
for surgical intervention and mortality of the patients with the number of
leukocytes and neutrophil-to-lymphocyte ratio (NLR) was investigated.

Results:  Of the patients, 104 (66,7%) were male, 52 (33,3%) were female, and mean age was
63,8±17,6 years. According to endoscopic findings, the most common cause of the
bleeding was peptic ulcer (77,6%). There was no statistically significant
correlation between leukocyte count and NLR and need for intensive care, need
for surgical intervention and treatment outcome. However, there was a
statistically significant relationship between NLR and length of hospital stay
(p=0,02)

Conclusions: Evaluation
of the patients with NVUGIB timely through their findings detected at admission
and their laboratory results would make a positive contribution to treatment
planning and follow up of the patient. Leukocyte count alone or in combination
with other clinical and laboratory parameters can be a valuable marker in
measuring mortality potential of acutely hospitalized patients. In our study,
we found a significant relationship between NLR and the average length of
hospital stay, which should be encouraged for further studies investigating its
relation with the prognosis of the  disease.

Keywords

Nonvariceal upper gastrointestinal bleeding, leukocytosis, neutrophil-to-lymphocyte ratio

Nonvarisial Üst Gastrointestinal Sistem Kanamalarında Klinik Gidiş ve Nötrofil-Lenfosit Oranı ve Lökosit Sayısı Arasındaki İlişkinin Değerlendirilmesi

Abstract

Amaç: Nonvariseal
üst gastrointestinal sistem kanamaları (NVUGIB) kanamaları yaşamı tehdit eden
ve mortalite oluşturan kanamalardır. NVUGIB’li hastalarda prognoz ve  mortalite için risk faktörlerini belirlemek
önemlidir. Biz bu çalışmada, NVUGIB li hastalarda, lökositoz ve nötrofil-lenfosit oranının
hastalığın klinik seyiri ile ilişkisini değerlendirdik.

Gereç-Yöntemler: Kliniğimizde, Eylül 2013 – Mart
2017 tarihleri arasında
NVUGIB tanısı konulan 156 hasta çalışmaya alındı. Hastaların
demografik verileri, endoskopik bulguları, eritrosit süspansiyonu ihtiyacı,
hastanede yatış süresi, yoğun bakım ihtiyacı, cerrahi müdahaleye ihtiyaç, ölüm
ile lökosit sayısı ve nötrofil-lenfosit oranı (NLR) ilişkisi araştırılmıştır.

Results: Hastaların
103’ü (%66,7) erkek, 52’si (%33,3) kadın, yaş ortalamaları 63,8 ± 17,6
saptandı. Endoskopi bulgularına göre kanamanın 
en sık nedeni peptik ülserdir (%77,6). Hem lökosit sayısı hem de NLR ile
yoğun bakım ihtiyacı, cerrahi müdahaleye ihtiyaç ve tedavi sonucu arasında istatistiksel
olarak anlamlı bir ilişki bulunmadı. Ancak Hastaların NLR’a göre hastanede
yatış süre ortalaması arasında istatistiksel olarak anlamlı bir ilişki vardı
(p:0,02)

Sonuç: NVUGIB sahip hastaların hastaneye
başvurusu sırasında saptanan bulguları ve laboratuvar verileri çerçevesinde
önceden değerlendirebilmek hastanın takibine, tedavi planlamasına olumlu katkı
yapmaktadır. Lökosit tek başına ya da diğer klinik ve laboratuar parametrelerle
kombine edilerek, akut olarak hastaneye yatırılan hastalarda mortalite
potansiyelinin ölçülmesinde önemli bir marker olabilir. Çalışmamızda NLR ile hastanede
yatış süre ortalaması ile anlamlı ilişki saptanmış olup, hastalığın prognozu
ile ilişkisini gösteren daha ileri çalışmalar yapmak için teşvik edici
olmalıdır. 

Keywords

Nonvarisial üst gastrointestinal sistem kanaması, lökositoz, nötrofil-lenfosit oranı

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